CHA Letter to DHA on Change to Reimbursement Methodology for Children’s Hospitals

CHA Letter to DHA on Change to Reimbursement Methodology for Children’s Hospitals

Children's Hospital Association sends a letter to the DHA seeking delay in implementation of final rule ending TRICARE’s exemption for children’s hospitals from the Medicare OPPS.

In July 2023, CHA sent a letter to the Defense Health Agency (DHA) to request a delay in the effective date of a final rule that ends the exemption for children’s hospitals from TRICARE’s outpatient reimbursement methodology which is based on Medicare’s Outpatient Prospective Payment System (OPPS).

The letter to DHA notes that children’s hospitals that care for children covered by TRICARE need sufficient time to analyze the implications for their individual institutions of the reimbursement change and make the requisite system changes to allow them to comply with OPPS. The letter also asks the DHA for additional information regarding the underlying assumptions and methods that were used in the rule’s fiscal impact analysis to support the financial modeling necessary to fully understand the implications for children’s hospitals.


Contact Us

For more information, connect with us.

(202) 753-5384

Related Content

CHA Shines Spotlight on Vital Role of Medicaid for Children of Military Families with New Report

Children’s hospitals are a crucial resource for the nearly 3 million military-connected children eligible for Medicaid and health care outside of the TRICARE system.

Nov. 28, 2023

Medicaid: A Vital Resource for Nearly 3 Million Military-Connected Children

Military-connected families and their children face stressors which impact their overall health and well-being, as well as their access to care.

Nov. 28, 2023

6 Ways to Engage with Medicaid Directors

Effective strategies for children’s hospitals to collaborate with state Medicaid programs.

Nov. 15, 2023